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Changes to the healthcare system are touted as major priorities for the new federal government under Barack Obama - and the new session of the state legislature - but facing a massive deficit in Hartford, and growing recession nationally - what change can we really expect? Today, Where We Live, we're joined by State Healthcare advocate Kevin Lembo - along with Senator Chris Dodd. He's kicking off a healthcare listening tour tomorrow in East Hartford.

We'll go through the tricky world of Health Savings Accounts and high deductible health plans - more and more workers are being moved into these plans as a way to save companies money.

John, the program on Where We Live today ( 1/22/09 ) on health care provision and costs in Connecticut was great and encouraging.

My opinion and experience is that our healthcare costs are being driven up inordinately because: [ these are not ranked by impact ]

Cost of physician liability insurance and precautionary actions taken to avoid being sued by patients Treatment and prescription authorization and payment administrative inefficiencies Preventative services unreimbursed by State and Federal governments and most company health plans ( unlike other developed countries ) Cost of treatments and prescriptions not visible to physicians and patients before treatment or prescription Absence of a uniform, national system of healthcare data collection regarding patient profiles, test results, diagnosis and outcomes ( like Findland ) Irresponsible lifestyles without penalties for patients ( major exception being tobacco use )

It is my opinion if each of the above defects in healthcare delivery were addressed and corrected reasonably, the total cost of healthcare to the public, employers and taxpayers would likely be reduced 30% to 40% and the growth rate of healthcare costs would be reduced very substantially.

A. I believe that a significant amount of testing and diagnostic services are prescribed to decrease the potential of law suits against physicians even though the probability of a major illness is very small. A second element driving up these costs are unjustified suits by patients and unwarranted awards of injury payments, particularly in actions by juries. [ Reference Item #1 above ]

From my very recent experience with trying to process my wife’s first prescription from a healthcare insurer that is new to me starting in 2009, the enormous waste of time by her physician’s office, by the insurance company, and by myself ( acting on my wife’s behalf ) are certain to have increase the actual cost of that medication by several hundred percent. Additionally, our healthcare insurance is provided by my former employer which itself did a miserable job of overseeing the planning for the transition from one insurer to another. [ Reference Item #2 above ]

Finally, the lack of visibility of treatments cots and medications costs before treatment or prescription, especially for patients, but also I think for physicians, results in uninformed decisions by both parties. The costs of these treatments and expensive prescriptions almost always are biased on the high side due to the pressure of physician liability and the desire for best available patient treatment even where the cost in unwarranted or unaffordable. [ Reference Item #5 ]

I hope the issues I have raised in this e-mail will be considered in the State of Connecticut discussions about healthcare delivery and insurance plans.

We are a middle class family with 2 working parents who are both self employed in businesses that have been adversely affected by the economic decline. We were paying a thousand dollars a month for health care coverage for ourselves and 3 elementary age children; in April of last year, we had to dump our health insurance because we could no longer afford the premium. We decided that, as long as no one became seriously ill, we would be better off paying out of pocket for our health care.

We have been frustrated to discover that doctors are charging us more for our visits than they are accepting, for the same service, from insurance companies. For example, they will accept $65 from the health insurance company for a well care visit that they are charging us $110 for. We have been told, when we asked about reducing our bill, that they cannot, as per their contracts with the health insurance companies, reduce their bill to private pay patients. How can this be allowed? Why do those who cannot afford health insurance have to pay more for the same service?